Provider Demographics
NPI:1073722294
Name:TUDI, SAVITHA R (MD)
Entity Type:Individual
Prefix:
First Name:SAVITHA
Middle Name:R
Last Name:TUDI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 THE MEADOWS
Mailing Address - Street 2:
Mailing Address - City:ENFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06082
Mailing Address - Country:US
Mailing Address - Phone:201-399-4362
Mailing Address - Fax:
Practice Address - Street 1:819 WORCESTER ST STE 3
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01151
Practice Address - Country:US
Practice Address - Phone:413-543-6820
Practice Address - Fax:413-543-7962
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA231545207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP00456259Medicare PIN